Overview of the Medical Services Advisory Committee (MSAC) Pull - PowerPoint PPT Presentation

Overview of the Medical Services Advisory Committee (MSAC) Pull quote Dr Sarah Norris Chair MSAC Guidelines Review Technical Reference Group 27 August 2020 www.health.gov.au

Australia’s Health System • Australia’s universal health system was introduced in 1984 to provide eligible Australian residents with affordable, accessible and high quality health care. Medicare comprises: • The Medicare Benefits Schedule (MBS) • The Pharmaceutical Benefits Scheme (PBS) • The National Health Reform Agreement (NHRA) • All Australians are entitled to: • Benefits for health professional services listed on the MBS • Subsidised drugs listed on the PBS • Public hospital services jointly funded by the Commonwealth and States/Territories 2

Medical Services Advisory Committee (MSAC) • MSAC was established in 1998 • MSAC provides advice to the Minister for Health on whether a medical services/device or health technology should be publicly funded on the MBS and the conditions of the listing (clinical condition and target population) • MSAC also appraises health programs (e.g. community pharmacy programs) and other health technologies funded through other public funding sources (e.g. blood products and blood-related products through the National Blood Authority) 3

Role of MSAC • Medical services assessed can be therapeutic, investigative or consultative • Health technologies assessed are broad; genetically engineered cells (e.g. CAR-T cells) and cancer screening 4

Role of MSAC • MSAC is a key part of the Australian Health System and is an internationally recognised expert body. • MSAC works with the Pharmaceutical Benefits Advisory Committee (PBAC) and the Prostheses List Advisory Committee (PLAC) to consider applications that are co-dependent i.e. health products/technologies that also require these committees to provide their advice to the Minister. • PBAC recommends new medicines for listing on the PBS, and PLAC advises on the listing of devices on the Prostheses List (and benefits) • The evaluation of evidence associated with medical services and health technologies are an integral part of the process for the Australian public funding of new medical technologies and services. 5

Role of MSAC • Meets regularly 3 times a year – March, July & November – generally 1-2 day meeting • MSAC’s size and composition is determined by the Minister for Health • MSAC advice is made available publicly on the MSAC website, in the form of Public Summary Documents • Application information is available on the MSAC website http://www.msac.gov.au/internet/msac/publishing.nsf/Content/appli cation-page 6

Membership of MSAC & Sub-Committees • MSAC Executive - MSAC may delegate some of its functions to its Executive sub-committee • MSAC Chair - Professor Robyn Ward • MSAC Deputy Chairs - Professor Tim Davis and Professor Kwun Fong • PASC Chair - Professor Andrew Wilson • ESC Chair – Professor Kwun Fong • MSAC and its sub-committees (PASC and ESC) have diverse membership and include experts in pathology, molecular genetics, cardiology, cardiothoracic surgery, general surgery, medical oncology, endocrinology, nuclear medicine, health economics, pharmacy, general practice, public health, epidemiology, and consumer representatives • The Chairs of PASC and ESC should be a member of MSAC and the MSAC Executive, and members are appointed by the MSAC Executive 7

MSAC Sub-Committees - PASC PICO (Population, Intervention, Comparator, Outcome) Advisory Sub-Committee • PASC oversees the development of the questions for public funding, using the PICO framework • Specifically PASC looks to: • capture current clinical practice and reasonably reflect likely future practice with the proposed new service/technology • identify all potentially impacted health outcomes and healthcare resources • present and justify the framework for evidence collection during the assessment phase of the MSAC process 8

MSAC Sub-Committees - ESC ESC – Evaluation Sub-Committee • The ESC reviews the clinical evidence and economic assessment presented in an assessment report in detail, and • Provide advice to MSAC on the quality, validity and relevance of the assessment, highlighting issues that MSAC will need to consider 9

Further information on MSAC webpage 10

Basis of MSAC’s advice • MSAC’s advice is based on health technology assessment (HTA); using the best available evidence to consider the comparative safety, clinical effectiveness, cost-effectiveness and financial impact of the service or technology • Does the service/health technology work? Who is it for? • Are there risks/harms? • How much does it cost? Is it value for money? • Are there any other social, legal ethical impacts? 11

What is Healt h Technology Assessment? • A process of systematically evaluating the quality, safety, efficacy, effectiveness and cost-effectiveness of health services or technologies using scientifically based evidence and methods to assess • A multidisciplinary process that uses explicit and scientifically robust methods to assess the value of using a health technology at different points in its lifecycle . The process is comparative, systematic, transparent and involves multiple stakeholders 1 1 https://www1.health.gov.au/internet/hta/publishing.nsf/Content/about-1 12

Why is Health Technology Assessment important? • Not every new health technology that comes onto the market, can be supported by the Government. • HTA informs policy, funding and clinical decisions, and assist with consumer decision-making • Ultimately HTA aims to direct government funding, in the form of subsidies, to health technologies that are clinically relevant, cost effective and safe 13

MSAC HTA Process Triage (pre- PICO Confirmation Pre-lodgement Application Assessment assessment) Assessment PICO PASC ESC Application Application Report development consideration consideration development assessment development Appraisal MSAC consideration 14

MSAC HTA Process Pre-lodgement Application development 15

MSAC HTA Process Triage (pre- Pre-lodgement assessment) Application Application development assessment 16

MSAC HTA Process Triage (pre- PICO Confirmation Pre-lodgement assessment) PICO PASC Application Application development consideration development assessment 17

MSAC HTA Process Triage (pre- PICO Confirmation Pre-lodgement Application Assessment assessment) Assessment PICO PASC ESC Application Application Report development consideration consideration development assessment development 18

MSAC HTA Process Triage (pre- PICO Confirmation Pre-lodgement Application Assessment assessment) Assessment PICO PASC ESC Application Application Report development consideration consideration development assessment development Appraisal MSAC consideration 19

MSAC Guidelines Review • The MSAC Guidelines provide practical information on how to present evidence to the MSAC and its sub-committees • Used by applicants and health technology evaluation groups and other interested parties • A review of the Guidelines has commenced to ensure that the MSAC assessment processes are aligned with best practice • Invitations for public comment on the draft revised Guidelines and to register for future MSAC Guidelines review webinars will also be issued in the near future 20

MSAC Guidelines Review • More information about the Guidelines review can be found: http://www.msac.gov.au/internet/msac/publishing.nsf/Content/guideli nes-review 21

MSAC’s Role and Guidelines Review Email: MSAC.Guidelines@health.gov.au 22